Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Track B: Clinical Science
Methods: Daily administration of 6 mg r hGH[nl], s.c., for I12 weeks in H
patients with CD4 < 200/pl and a minimum weight loss of 10% n t,
weight less than 90% of the lower limit for ideal body weight. Al.,( ce
infection (OI) or active malignancy Body composition was deter r
Impedance Analysis (BIA).
Results: 12 of 14 enrolled patients completed the 12 week foli,,p
dropped out, (Day 4: due to oedema, nausea, headache, and WE i.:
pneumonia). 8/12 patients were considered treatment successes
increase (n = 5) in mean BW (6.4 ~ 1.6 kg), LBM (7.4 ~ 2.5 kg). I
stabilisation (n = 3) of previous severe wasting. 4/12 patients had
Conclusion: In about 70% of the patients a beneficial effect of tre' n,r
(SerostimTM, Ares-Serono) was achieved by either increase of h<,!(,,
or at least stabilisation of previous progressive wasting.The result t e
hGH[mr], as a promising treatment of HIV-associated wasting.
Stephan Klaude, M.D. Klinikum der J.W Goethe-Universitdt, ZIMin c
Frankfurt/Main, Germany Telephone: (49) 69 - 630 I 66 3 Fax: (9

Mo.B.1385 - Mo.B.1389

IV i(ietI male Gcroup II: 8 patients received placebo at the same quantity and administration route. Both,:tr or a body groups received the treatment for four weeks, attending the hospital for the administration
of opportunistic of the medicine, during this time diet, intercurrent diseases and attachment to the treat ar Bioelectrical ment were evaluated daily. After the 4 weeks of treatment there were a great difference
between the two groups, the study was opened and both groups autoadministered rh-GH, 5; r, ts at home with the same dose for a time of 12 weeks, during this time they were evaluated
S, )1 asipergillus every 7 days.
Siu,usbstantial Results: The results are shown in the following chart:

5kg) or
wI!t -h(1Hr2m
/ /,i.t lBM and BCM, - onfirm r-?( /- ( 1!7 12

Week 0
Group I Weight (in Kg) 49.8 + 5.7
i rinx y BUN (mg/dl) 699.6 + 182.2
Group II 'Veight (in Kg) 489 - 4.5
riii jry BUN (mg/dl) 6443 + 247.5

Phase I
Week 4
50.5 5.4
467.9 ~ 150.7
48.8 ~ 5.0
54.4 a 122.0

Week 0
49.8 5. 7
699.6 + 182.2
488 5.0
5434. 122.0

Phase II
Week 12
56.5 + 6.3
381 0 94.5
28.7 t 5
3 8.7? t 15,1

Mo.B. 1385
FISH OIL IN THE TREATMENT OF WASTING SYNDROME
Scevola, [5, Oberto L*, Faggi A*, Sacchetta AC*. 'University of P, i i 5 Policlinico
S.Matteo, Pavia, Italy; **Zyma Medical Department, Saronno, Italy
Objective: To determine the effects of a formulation of fish oil (e soeripntaenocr acid = EPA
I 8 % and docosahexaenoic acid -= DHA I 2 % with vit.E 3 mg /, s a ntioxidant) on body
weight and composition, serum lipids and TNF levels in AIDS related iwa1vvsin syndrome.
Methods:Twenty AIDS patients (stage IV C) having lost > I 0% iof their usual weight, with
hypertriglyceridemia (> 1 60 mg / dl), with or not hypocholestenrleni i, (< 150 mg / dl) and
dosable TNF were randomly assigned to receive a dietary regimen c staining or not fish oil
(10 g / d / orally for 30 days). Body weight, body composition, plasn tngy e ides, cholesterol and TNF, caloric intake were measured baseline and after 30 d- f t iatment.
Routine clinical, biochemical, immunological parameters were obtrined.
Results: The subjects of the two groups at entry were comparable bu!t at the end only who
received fish oil (n= 10) showed statistically significant modification, of studied parameters.
The mean weight gain was 2.4 kg; the lean and fatty body masses rspe iwily increased of
1.4 kg and 0.67 kg; the triglycerides decreased from 230 mg / dl to 149 rng / dl anrid choles.terol increased from 169 mg / dl to 200 mg / dI.TNF levels decreased from 60 pg / ml to
88 pg / ml. Caloric intake passed fore < 1550 kcal / d to > 2200 kcn / d.
Conclusions: The sub-set of AIDS patients affected by wasting syndrme sitt high levels of
triglycerides and TNF and low cholesterol may benefit fiom addition to diet ofl adequate
amounts of fish oil containing n-3 PUFA that decrease inflammatory toknres production
and futile metabolic cycles.
Daniele Scevola, Institute of Infectious Diseases, University of Pavia, Itaiv
Tel:lnt 382 502-672 Fax: Int - 382 - 423-320
Mo.B. 1386
SHORT AND LONG TIME TREATMENT WITH GROWTH HORMONE IN AIDS
WASTING SYNDROME INCREASE IN QUALITY OF LIFE, NUTRITIONAL AND
STATUS.
Gomez-Caro Williams Humberto, Feregrino-Goyos, M., Alvarado Diez. R.,II dt G.,
Conde-Mercado J. M., Fuentes-Del -Toro, S. Mireles- v. Mp., Mora- Pdrigue/. G. CITAID
(Center for reasarch and advanced treatment in Inmunedefficienc SCod. t vital deo
Especialidades Dr. Bernerdo Sepulveda del cmn s xxi, imss, Mexico D F Mc" -.
Objectives: To the use of growth hormone in patients with wasting syndroie Sr AIDS
improve the quality of life, metabolic nutritional and immune respoDse, to co pa re its use
in patients with acute vs. chronic Wasting Syndrome of AIDS.
Methods: We did evaluate 1 6 patients with advanced AIDS and as te or:hronr W. S. with
CD4 count very low, but stable with antiviral combined treatment according to viral load
and response. We for med two groups.The group I with t0 patieots, wit stab le disease and
Nutritionalstatus normal., but when they presented O. I. they develop aertSe W. S. in I week
with weigh loss of 4-8 kg.They received treatment of. I. and NP I fcr 5 8 days continues
with Enteral Nut Sup (ENS).They received growth hormone for 25 days +5 sc at 0.2
Us/Kg/weight /dayThe patients of the group 2 (6) with chronic w asting synd rome for previous 0. 1. received Grow Hormone O. I Us/Kg/day by 100 ~ 80 days rid NPT for 25 d and
continues with ENS for more than 100 days. according with reqiieereent i both groups.
We evaluate N balance, weight evolution, antrophometric measures,.Muscular mass, Karnofs
ky Index, and statistical with Parametric and Non parametric (ANOVA).
Results: The group I had good evolution with mortality average or 0 S(I) increase w.b. 4k
in 25 days, K. I. increase from 40 to 80 (p<0.0 1), Muscle mass increasedr om 14 to 19 cm
(p0.05). with fit mass from 1.8 to 2.3 mms. (p<0.05).The CD4 inceie 509P 0.05). N.
Balance from - 12 g/d to +8 g /d. and good evolution of sepsis, per iton yis, surgery, and O.
I. The group 2 had Mortality average 50%, increase in weight body Is-om 5a<g to +8 kg.
(p<0.05 Muscle mass increase f6om 8to 12.5cm (p<0.I). Fat mass iora 2 to 20
mm(p<0.05).K.I. from 40 to 60 points. N. balance from-8g/day to +?g,/d. In 4 patients we
observed suppression synd. when stop Growth H.
Conclusions: The best results were in Acute WS. and minor in CIron ic VV S.
W. H. Gomez Caro MD. Alfonso # 162 Col. Alamos Mexico DF CP 01C)00 Mexico DF
Mexico tel [phone] and FAX [phone]
Mo.B. 1387
GROWTH HORMONE IN THE TREATMENT OF LOSS WEIGHT AIDS-RELATED
Luna Castanos German, Osornio Leticia, Gomez Dulce M, Nieto Leopoldo. Internal
Medicine Department. Gabriel Mancera General Hospital IMSS. Me:'i, o D. Mexico
Objective: To establish the use of the human recombining growth rr none obtained from
mammals cells (rh-GH) in the WL treatment in patients with AIDS
Methods: From a total of 337 patients that the AIDS clinic has, 37 patient's were considered
is candidates since they satisfied the following inclusion criteria:. I.Age - 18 years; 2.WL
> 10% of the usual weight; 3. Karnofsky's index >50; 4. Absence of actie infetion; 5.
Agreement to participate in the study Nineteen patients were r, lyr chosen and then
divided in two groups: Group I: I I patients who received rh GH 01 6 r1IU/Kg/a day SC.

L iqu d reterntion was observed in one patient as a collateral effect, another patient present
ed allergy to the rh-GH which was successfully resolved with antihistaminics and with a 10
fly desersibilitation program.
Conclusions: The results show a favorable effect, that favours its use in patients with AIDS
and WL as well is a larger study groups with longer follow-ups.
German u lun Ciastanos, Progreso I 85 204 Col. Escand6n, C.P I 1800 Mexico City, Mexico.
Tel.: [phone] Iax: 280-5945
Mo.B.1388
THE EFFECTS OF CHRONIC GROWTH HORMONE THERAPY ON DIETARY
INTAKE IN PATIENTS WITH HIV-ASSOCIATED WEIGHT LOSS
TaI Via W, Mulligan K. Culp J, Schambelan M. University of California San Francisco, Sani
Francisco, CA, USA
Objective: o determine the role of energy intake in the changes in weight and body composition that occur with recombinant human growth hormone (rhGH) treatment of
patients with HIV associated wasting.
Methods: 3velve subjects enrolled at the Sanri Francisco General Hospital (SFGH) site of a
riulticenrter trial of rhGH (average dose 6 mrg/day) for HIVassociated wasting (mean I 1~4
Kg) kept 7-day food diaries prior to and at the end of 3 months of treatment. Food records
were analyzed using Nutritionist 4. Body composition was measured by DEXA.
Results: At 3 rnonths, weight and fat-free mass (FFM) increased and fat decreased
=p<0.005 by paired t-test), as observed in the nationwide cohort and in the larger group
atof patients studied at SFGH.These changes in body composition occurred in the absence of
any si gnificant increases in energy protein, fat, or carbohydrate intake.

Wt, Kg FFM Kg Fat as, Kg Kcal/da _y Kcal/Kg Protei n,
Baseline 61.317.2. 51/9~8.4 8.7~2.7 2647~805 42.0~11.5 104-35
3 Month 65.2~8.3 55.5~+8.1 6.9~2,7 2841 /36 43.31~8.7 102~128
A +2 0) 3.6+1.1* 1 - 9~1. 194~828 13t12.6 I31

Fat Intake, g CI), g
93~44 352~1I7
106~26 377+ 16
131~41 24~ 128

a)
Ca
r3
4)
d)
C3
i,,l
C)
122
'-3
CF)
C)
C)
5-)
cC)
Urc
Ca.__
+22

Although not statistically significant, the mean increase in energy intake (200 kcal/d) could
esult in we ght gain over 3 months, but chronic increases in lipid oxidation and resting
energy expenditure (230 kcal/d) might obviate this effect.
Conclusions: In contrast to appetite-stimulating therapies, treatment with rhGH resulted in
weight gain in the absence of any substantial net increase in energy intake.These results are
consistent with our previous findings in a metabolic ward study in which rhGH caused
weight gain and nitrogen retention during a period when energy intake was fixed.The loss
of fat noted during chronic therapy coupled with persistent increases in lipid oxidation,
point to utilization of endogenous fat stores as a supplemental source of fuel for synthesis
and maintenance of FFM.
Viva W.Tai, RD MPH, UCSF Department of Endocrinology San Francisco General Hospital,
Building 100 Room 32 1, San Francisco, CA 94 I I0 Phone: [phone] Fax: [phone] I 8
E-mail: vtai(@sfghgcrc.ucsf.edu
Mo.B. 1389
BODY COMPOSITION AND RESTING ENERGY EXPENDITURE IN WOMEN WITH
HIV INFECTION
MLulligan, Kathleen,Tai VW, Greenblatt R, Schambelan M. University of California, San
Francisco, San Francisco, CA, USA
Objective: To evaluate the effects of HIV infection on body composition and resting energy
expenditure in HIV-infected women and compare these results with similar observations in
HIV+ men.
Methods: Weight, body composition, and resting energy expenditure (REE) were compared
in groups of HIV+ women, HIV+ men, and respective controls. Controls were selected to
have a body mass index (BMI) within a range that corresponded to the extrapolated preweight loss BMI in those with wasting. Fat and body cell mass (BCM) were estimated by
bioimpedance analysis and REE by indirect calorimetry
Results: Seven women had self reported weight loss > 10% (mean -8.0~0.7 kg). As we have
noted with men, both BCM and fat, adjusted for height, were significantly lower in women
with weight loss, compared to controls. In women, fat comprised a greater proportion of
the difference in weight between those with weight loss and controls (89% in women; 67%
in rmen).This result is consistent with the observation that the proportion of weight lost as
tat increases with initial body fat content, which is typically greater in women (33 vs. 18% in
our control groups of women and men, respectively).

HIV> VVt lo,,s
HIV+ CD4< 200
HIV+ C4>200
HIV control

N Age (yrs)
7 40~3
7 38+3
7 40~4
19 38~+1

CD4+ (/mm3)
36~+17
74~ 14
546~ 103

BMI (kg/m2) BCM/ht (kg/m)
9.411.0 I.3~0.3
21.3~ 1.2 1.6~0.5
23.5~0.6 1 19~0.4
24.010.4 129.9~0.2

Fat/ht (kg/m)
8.4~1. 6
11.1~ 1.5
13.2+0.7
13.0~0.8